The bottom line for successful control of blood sugars is predictability. It is impossible to use insulin or medications unless you can predict the effects they will have. Nor can you normalize blood sugars unless you can predict the effects of the foods you eat.
Until you become an expert in predicting your blood sugars, following one rule will save you the ill effects of low blood sugars and high blood sugars alike:
Small inputs lead to no more than small errors.
Since 2004, the American Diabetes Association (ADA) has recommended a minimum of 130 grams of carbohydrate per day for diabetics, with 65 per cent of calories as a maximum. For extremely active diabetics, then, the ADA recommends up to 400 grams of carbohydrate per day.
What neither the ADA nor the side of the box will tell you is that food manufacturers are permitted an error of plus or minus 20 per cent in their labeled ingredients. So even if you eat exactly what your diet requires, exercise exactly the number of minutes your doctor recommends, and take insulin and other medications precisely on schedule, your blood sugars can run seriously high or seriously low on the ADA diet.
How much of a problem can variation in ingredients be? Let’s say you ate a large plate of pasta labeled to contain 150 grams of carbohydrate, the maximum the ADA recommends for each meal. Variation in manufacturing practices means the actual carbohydrate content of your meal could be anywhere from 120 grams (20 per cent low) to 180 grams (20 per cent) high. If you are a muscular type 1 diabetic who weighs 180 pounds (80 kilos), 1 gram of carbohydrate will raise your blood sugars about 3 mg/dl. Even if you are doing everything else right to keep your blood sugars at 90 mg/dl, your actual blood sugars may range anywhere from 180 mg/dl to 0 mg/dl. At 180 mg/dl, your cells protect themselves from autooxidation of glucose, which is essentially glucose burning the in the bloodstream before it ever reaches its destination. To deal with the surge of free radicals, cells make sure they do not absorb toxic levels of glucose by becoming insulin-resistant. This means that whatever you are doing right before won’t work quite as well the next time you do it. At 0 mg/dl, of course, life ends, although chances that long before you became unconscious you would experience hunger. Your appetite leads you to make up the missing carbs and then some, causing your blood sugars, and your energy levels, to swing up and down. It is not unusual for diabetics’ blood glucose levels to vary between 40 mg/dl (dangerously low) and 400 mg/dl (dangerously high) throughout the day every day, but averaging nearly normal. The HbA1C readings your doctor takes every three months may not show much is out of balance. Extremely high blood sugars after every meal, however, make your cells insulin-resistant, whether or not you are insulin-dependent.
"Natural" foods, especially fruits, can have even greater variation in carbohydrate content. A 3-1/2 ounce (100 gram) apple is generally counted as containing 12 grams of carbohydrate. Different varieties of fresh apples, however, may have anywhere from 11 to 16 grams of carbohydrate (Hecke and collaborators, 2006). Apples picked during a drought year, however, may contain as much as 40 grams of carbohydrate per 100-gram serving, more carbohydrate than in apple pie!
Variation in the carbohydrate content of foods is not the only consideration. Your stomach empties your meal so it can provide carbohydrate more quickly the more thoroughly you chew – or if you chew gum after eating. Your stomach empties your meal more slowly if you consume foods with lots of fiber or if you eat foods prepared with cinnamon. Either way, the more carbohydrate you eat, the more likely your body’s own or injected insulin is not going to be up to the job.
Most insulin-dependent, type 1 diabetics know that it is possible to "cover" a bowl of pasta or a piece of pie by taking an unusually large injection of insulin. Blood sugars soar for a few hours, but insulin eventually is able to bring them down. In many type 2 diabetics, the body "covers" unusually high carbohydrate loads without the diabetic ever knowing it.
The problem in both cases is that for a period of several hours to a day the body suffers the ill effects of high blood sugars. The nerves, the eyes, the heart, and the kidneys are all susceptible to the ravages of glycosylated hemoglobin even if hyperglycemia is temporary. Cells throughout the body become resistant to insulin to prevent the flood of free radicals associated with extremely high blood sugars after high-carb meals.
The good news is, if you consume only small amounts of carbohydrate at each meal, you can easily prevent both high and low blood sugars. All diabetics can prevent soaring blood sugars after meals by taking fast-acting insulin before meals. Many type 2 diabetics are able to prevent high blood sugars through their own phase-1 response, as long as the carbohydrate is slow-acting and portions are small.
Read Do Diabetics Need Lipitor and Lower Blood Sugars 1-2-3. Robert Rister is author of nine books and over 2,000 articles on natural health.
